Guest Editorial: Forensic psychiatry in Africa: prospects and challenges

Forensic state patients at Sterkfontein Hospital: A 3-year follow-up study

“…[1,2,4] There is a paucity of SA-published research in the field of forensic psychiatry. [6][7][8] Although there is literature regarding the profile of state patients, very little is found regarding long-term outcomes, particularly the duration of hospitalisation, discharge and reclassification details, absconder rates, and rehospitalisation and recidivism rates following release back into the community. [6,9] Moreover, forensic psychiatry in SA faces several challenges.…”

“…These include a limited number of forensic psychiatric facilities and a shortage of qualified psychiatrists involved in forensic psychiatry in the state sector. [7] Sociopolitical and socioeconomic factors, such as high levels of crime, poverty, inequality and unemployment, and various shortcomings of the often criticised South African Police Service (SAPS) are further challenges, as they promote non-adherence, poor social support and an increase in relapse rates among mentally ill persons. [10,11] The aim of this study was to describe the profile of state patients who were admitted to Sterkfontein Psychiatric Hospital (SFH) during the years 2004 and 2005 and to examine their 3-year outcomes.…”

“…[6,9] The finding that less than a third of state patients were still inpatients at SFH after 3 years, with the majority (69%) back in the community, is in keeping with the trend towards deinstitutionalisation, where the aim is to treat and reintegrate mentally ill offenders back into their communities, with further outpatient treatment and follow-up. [1,2,7,26] In the SA context, it should also be questioned whether and/or to what extent overburdened psychiatric state hospitals, as well as the backlog of patients awaiting admission for forensic psychiatric observation, may have contributed to this trend. [7,27,28] The most common reasons for state patients remaining inpatients at SFH after 3 years, in this study, were still considered mentally unstable, a high risk of reoffending, and having poor social support.…”

“…[1,2,7,26] In the SA context, it should also be questioned whether and/or to what extent overburdened psychiatric state hospitals, as well as the backlog of patients awaiting admission for forensic psychiatric observation, may have contributed to this trend. [7,27,28] The most common reasons for state patients remaining inpatients at SFH after 3 years, in this study, were still considered mentally unstable, a high risk of reoffending, and having poor social support. These findings are similar to reasons described in the literature.…”

Forensic psychiatry in Rwanda

“…When such descriptions are available, they concern almost exclusively the North and South regions of the continent [6]. However, it was observed that the situation of forensic psychiatry in most sub-Saharan and central African countries is extremely preoccupying.…”